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The government’s cack handed reform of junior doctor training came a cropper last year – not least because they had to honour their obligations to overseas doctors who’d trained here. But as Dr David Nicholl reports, the door is still open to migrant medics, even though there’s already an over-supply in this country.

In all the furore over the failed doctors training system, Modernising Medical Careers, no-one at the Department of Health seems to be have been talking to the Home Office about changing the rules on medical immigration.

I can exclusively reveal that in spite of losing a court case over its attempt at retrospectively banning overseas doctors from applying, the government seems to be spending more time on trying to win an appeal in the House of Lords rather than correcting the failed migration policy that led to some of the problems in the first place.

Amazingly over 2000 HSMP (highly skilled migrant programme) permits have been issued to doctors who have trained overseas SINCE the problems of MMC started a year ago.

These permits are essential for any non-European Union doctor to work in the UK. This figure came from Home Office minister, Liam Bryne, in a series of written Parliamentary questions through my MP and those of colleagues of mine.

Just over 47,000 visas have been issued since April 2006 for a whole variety of professions, not just medicine, but the devil is in the detail, as over 2000 permits have been awarded in the last year for doctors from overseas.

This was like adding petrol to the fire, when the government could have quite legitimately stopped issuing any further HSMP permits - instead they have kept issuing them, significantly increasing the chances of those junior doctors already in the UK ending up out of work.

Yet no data is actually kept as to what speciality such doctors are from - this is clearly crazy as although there is a problem of medical over-supply (the Royal College of Physicians estimate a need for as many as an additional 10,000 training places over the next 10 years in order to avoid significant medical unemployment).

Clearly we need a valid process to allow migration of doctors in those specialties which are under-subscribed such as obstetrics and anaesthetics, yet when neither the Home Office nor the Department of Health collects the data on which specialty those applying for HSMP status represent, is it any wonder what a mess we are in?

Recently Dame Carol Black, President of the Academy of Medical Royal Colleges, told the Health Select Committee “In 1997, the government decided it would become more self-sufficient.

“That was the time they should have been in conversation with the Home Office about transition and preventing IMGs (international medical graduates) being disadvantaged in the way they have been. It was a failure of two policies to come together.”

Joined up government, in your dreams!

Sir Liam Donaldson has told the same committee "My own view is that I do not really accept the assessment that there is an oversupply of doctors."

Isn’t it time for those responsible for such a cock-up to do the decent thing and resign, and maybe consider a maths lesson.

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